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The effect of multiple triage points on the outcomes (time and accuracy) of hospital triage during mass casualty incidents.
Açiksari, Kurtulus; Koçak, Mehmet; Solakoglu, Görkem Alper; Bodas, Moran.
Afiliación
  • Açiksari K; Department of Emergency Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
  • Koçak M; Department of Emergency Medicine, Primary Health Care Corporation, Doha, Qatar. Electronic address: mkocak@phcc.gov.qa.
  • Solakoglu GA; Department of Emergency Medicine, Faculty of Medicine, Istanbul Medeniyet University Istanbul, Turkey.
  • Bodas M; Department of Emergency & Disaster Management, School of Public Health, Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, Israel.
Injury ; 55(5): 111318, 2024 May.
Article en En | MEDLINE | ID: mdl-38238120
ABSTRACT

INTRODUCTION:

During mass casualty incidents (MCIs), the accuracy and timing of the triage of patients by the emergency department (ED) triage officers are essential. The primary triage is performed at the event's location by paramedics and intends a quick evaluation of the victims. Secondary triage may be used when the transfer of the victim is delayed. In this study, we aimed to investigate the effectiveness of two-point triage in a simulated environment of an MCI in the hospital setting. MATERIALS AND

METHODS:

In this case-control study, we used an online test module to assess single triage points (Group 1, n = 41) and two triage points (Group 2, n = 40). 60 vignettes for Group 1 and 55 vignettes (5 deceased cases removed) for Group 2 were used. The assessment utilized clinical MCI scenarios in a scheduled online meeting by using the Simple Triage and Rapid Treatment (START) system. Triage time and accuracy of the triage, along with the experience, and previous training of the participants, were assessed.

RESULTS:

A total of 81 triage officers participated in this study. The participants were divided into two independent groups homogenously according to their profession and experience. Groups were comparable primarily without any statistically significant difference in terms of the profession (p = 0.101), sex (p = 0.923), and MCI experience (p = 0.785). The difference between the two groups was not significant with regard to having received practical or theoretical triage training (p = 0.099). The mean time of a single vignette triage was 19.2 (SD 6.5) seconds and mean percentage of correct triage score was 65.0 (SD 12.6). The participants had a statistically significantly better performance in the single-point triage group regarding the median triage time (p < 0.001) and median percentages of under triage (p = 0.001), but a worse median percentage of over triage (p < 0.001). However, there was no significant difference between the two groups in terms of the percentage of accurate triage. Emergency residents performed better in accuracy and triage time than their non-physician colleagues (p = 0.019).

CONCLUSIONS:

Two-point triage does not demonstrate better outcomes in terms of accuracy and timing. Triage officers should be trained frequently with the preferred training methodology to prevent improper triage accuracy and timing. Well-defined medical disaster planning should include frequent training of the triage officers with case scenarios.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Planificación en Desastres / Servicios Médicos de Urgencia / Incidentes con Víctimas en Masa Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Injury Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Planificación en Desastres / Servicios Médicos de Urgencia / Incidentes con Víctimas en Masa Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Injury Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Países Bajos